Domestic Minor Sex Trafficking Matt Baldock, Deputy Prosecuting Attorney Paula Skomski, ARNP, SANE-A

Objectives Define Domestic Minor Sex Trafficking State the forms and prevalence of DMST within the U.S. State the prevalence of DMST locally and regionally State risk factors for victimization Identify characteristics of trafficked youth Describe how to intervene and refer for services

What is it? Commercial Sexual Exploitation of Children (CSEC) generally refers to the sexual abuse of minors for economic gain. Prostitution Production of pornography Drug dependence “Survival sex”

Scope of Problem 100,000 - 300,000 American children are victims of Domestic Minor Sex Trafficking (DMST) at any given time annually. (U. S. Department of Justice, 2010; National Institute of Justice, 2007; Shared Hope International, 2009) Domestic Minor Sex Trafficking is one form of human trafficking and according to the U. S. Department of Justice (DOJ, 2010), the National Institute of Justice (NIJ, 2007) and Shared Hope International (2009), conservative estimates state there are at least 100,000, and possibly up to 300,000 American children who are victims of Domestic Minor Sex Trafficking (DMST) at any given time annually.

Scope of the Problem Seattle/King County : Estimates 300 – 500 (Boyer, 2008) Snohomish County: Estimates 30-50 No good empirical data: This is improving with local agencies now tracking victim contacts Up to 70% of street youth are CSEC victims (Greene, Ennett, and Ringwalt) Numbers are estimates because girls are frequently moved in and out of the area. These numbers only indicate the numbers of girls on the streets and do not take in to consideration girls being trafficked out of or in their homes, or being trafficked through pornography. The circuit that local girls are frequently moved around includes California, Arizona, Nevada, Oregon, Idaho and Washington.

The Victims 13 years old is average age when victims first introduced into to commercial exploitation Targeted Runaways or “throwaways” Prior abuse Mostly female

48 admitted victims 27 between 15 and 18 years old

“The juvenile prostitute is not seen by society as a worthy victim, while the sexually-abused child is. We must realize they are one and the same.” Identifying and Combating Juvenile Prostitution Nat’l. Assoc. of Counties, Inc. 1987

The Paradigm Shift Prostitute VICTIM Defendant Runaway Street Kid

The Law in Washington Trafficking Commercial Sexual Abuse of a Minor Class A Felony, 8-18 years Commercial Sexual Abuse of a Minor Class B Felony, 2-10 years Promoting Commercial Sexual Abuse of a Minor Class A Felony, 8-26 years

The Law Enforcement Approach Multi-Disciplinary Model Advocacy Medical Care Housing/shelter Counseling

Risk Factors History of sexual abuse Runaways Foster Care This is the number one risk factor Runaways Foster Care Low Self Esteem Living in high crime areas Poverty Any young person is potentially at risk of being manipulated by a pimp or trafficker but runaway youth are at the highest risk. Another factor that increases a girls’ risk for being trafficked is a history of childhood sexual abuse, it is estimated that as many as 90% of trafficked girls were sexually abused prior to becoming involved in prostitution (Leitch & Snow, 2010; Lloyd & Orman, 2010; Smith, et al., 2009; HHS, 2007). Another risk factor is placement in foster care. Familial disruption destroys stability and being placed into foster care significantly increases the likely hood of DMST by some estimates as much as 78% (Coy, 2009; HHS, 2007) Other risk factors include low self esteem, living in areas of high crime, poverty, lack of education and lack of employment opportunities

Additional Risk Factors Walk to school or to the store alone Own or have access to a computer Are attracted to consumer goods Desire to develop romantic relationships Feel misunderstood Fight with their parents Sometimes feel their parents don’t care Want more independence Test boundaries and take risks (GEMS, 2009) Shopping malls, parks, and our schools are common areas where girls are targeted. All behaviors common to teens.

Entry to DMST Seduction and coercion Peer recruitment Internet enticement through chat rooms, social networking, or profile-sharing sites False advertising for “modeling,” “acting,” or “dancing” opportunities Violence and force Parents selling children Kidnapping (GEMS, 2009) How do young girls get involved in DMST? There are multiple entry pathways which add to the complexity of this problem as there is no one prevention measure that may be effective. While kidnapping is often thought of the most common cause, it is actually more typical with foreign cases.

Recruitment Befriend potential victim Offer gifts, shelter, protection Develop trust Isolate from family and friends Develop sexual relationship Manipulate into sex with friends Sells her to others Gang involvement Lured in by “The Man, The Money or The Life” (Shared Hope International, 2010; Smith et al., 2009) Traffickers hang out where kids hang out; parks, malls, and schools. They target vulnerable young girls/boys and begin conversations to learn their weaknesses then they begin to fill those voids by offering gifts, shelter or protection to gain her trust. They may send one of their girls to do their recruiting because often girls will trust another girl rather than a guy. This behavior quickly moves to isolating the girl from her family and friends.

Identifying DMST Youth Talk of a much older boyfriend Money, cell phones, make-up, nails, hair that isn’t explained Tattoos Visible signs of abuse Transformation of physical appearance Lack of ID or false ID Staying in motels or having motel keys Travel/Vacations to other areas Sexually explicit online profile Language

Needs of DMST Youth Safety Housing Health care Counseling Education Legal Assistance Re-integration (Boyer, 2008; Choi, et al., 2009; Clawson, 2010; Leitch & Snow, 2010; Lloyd & Orman, 2010; Logan, et al, 2009; Mukasey, et al., 2007; NCMEC, 2002; Scott & Harper, 2006; HHS, 2011; Zimmerman, et al., 2008)

Interacting Provide a safe environment Address immediate needs Don’t be judgmental Gain trust and confidence (GEMS, 2009; Shared Hope International, 2010; Smith et al., 2009) Now that you have identified a potential trafficking victim, what do you do? First of all make sure that the environment for conversation is safe for the girl and for you. Show an interest in her well being and do not judge her decisions or behaviors. Ask what her immediate needs are and what you can do for her right now. Don’t be offended if she is not cooperative, hostile or is not ready to leave her trafficker. Establish trust by reassuring her that you will be there if she needs anything.

I am not a victim! There is a psychological bond between the pimp and the victim called trauma bonding (Stockholm Syndrome) The result is Failure to self-identify as a victim Repeated returns to pimp Denial of violence/abuse/exploitation Two primary physiological states Hyper-arousal: Anger, panic, tantrums Hypo-arousal: Flat affect, dissociation, daydreaming, inattention

Indicators of Trauma Bonding Denies violence when it is obvious it is occurring Believe they have some control over abuse Self-blame for situation and abuse Hyper-vigilant to pimps needs Sees world from the pimps perspective

Be prepared to deal with… Ambivalence You can’t talk them into changing so don’t try Difficult behavior Dishonesty Recantations Don’t get frustrated They have been manipulated by the pimp to act the way they do and to not trust people in roles of authority

What is helpful Meet the client where they are and follow their lead Meet basic needs Let them know that regardless of their choices you will support them Validate their strengths and skills Ask what they would find helpful now

Intervening Gather identifying information Talk with victim about a safety plan Call the Hotline 425-258-9037 (Snohomish County) National Hotline 1-888-3737-888 If you identify a trafficking victim gather as much identifying information as possible about her and the trafficker including street or nick names as law enforcement are often familiar with these names. Talk with the victim about safety issues, convey your concern for her health and safety, ask her how you can help her at this time. Call CPS and law enforcement, make it clear to them that this patient may be a trafficking victim. You can ask to speak to the FBI- Innocence Lost Task Force Officer. Try not to let the victim leave with a potential pimp or trafficker if they are with her. Make sure that everyone involved is safe, pimps and traffickers can be very dangerous people.

Summary Domestic Minor Sex Trafficking is a problem in every community which is complex and requires a coordinated community response. To combat this problem it is important to know the risk factors, signs of possible victimization, local resources to help and how to safely intervene. Healthcare providers are in key positions to interact with youth at risk for, or involved in trafficking everyday in various practice settings. Providers have the opportunity to provide prevention education regarding trafficking and to intervene when victims are identified.

Contact Information Matt Baldock mbaldock@snoco.org Paula Skomski paula.skomski@providence.org

References Boyer, D. (2008). Who pays the price? Assessment of youth involvement in prostitution in Seattle. Seattle, WA: Boyer Research. Clawson, H. (2010). Study of HHS programs serving human trafficking victims. http://aspe.hhs.gov/hsp/07/HumanTrafficking/ Cole, H. (2008). Human trafficking implications for the role of the advanced practice forensic nurse. Journal of the American Psychiatric Nurses Association , 14 (6), 462-70. Coy, M. (2009). Moved around like bags of rubbish nobody wants: How multiple placement moves can make young women vulnerable to sexual exploitation. Child Abuse Review , 18, 254-66. Dovydaitis, T. (2010). Human trafficking: The role of the health care provider. Journal of Midwifery & Women's Health , 55 (5), 462-67. Girls Educational & Mentoring Services. (2009). GEMS. http://www.gems-girls.org

References Kalergis, K. (2009). A Passionate practice: Addressing the needs of commercially sexually exploited youth. Journal of Women and Social Work , 24 (3), 315-24. Kotrla, K. (2010). Domestic minor sex trafficking in the United States. Social Work , 55 (2), 181-7. Lebloch, E., & King, S. (2006). Child sexual exploitation: A partnership response and model intervention. Child Abuse Review , 15, 362-372. Leitch, L., & Snow, M. (2010). Intervene: Identifying and Responding to America's Prostituted Youth. Vancouver, WA: Shared Hope International. Lloyd, R., & Orman, A. (2010). Training Manual on the Commercial Sexual Exploitation of Children (CSEC). New York: Girls Educational and Mentoring Services (GEMS). Logan, T., Walker, R., & Hunt, G. (2009). Understanding human trafficking in the United States. Trauma, Violence & Abuse , 10 (1), 3-30.

References Mitchell, K., Finkelhor, D., & Wolak, J. (2010). Conceptualizing juvenile prostitution as child maltreatment: Findings from the national juvenile prostitution study. Child Maltreatment , 15 (1), 18-36 Moynihan, B. (2006). The high cost of human trafficking. Journal of Forensic Nursing , 2 (2), 100-101. Mukasey, M., Daley, C., & Hagy, D. (2007). Commercial sexual exploitation of children: What do we know and what do we know about it? Washington DC: U.S. Dept of Justice. National Institute of Justice. (2007, October 25). Human Trafficking. http://www.ojp.usdoj.gov/nij/topics/crime/human-trafficking/ Sabella, D. (2011). The role of the nurse in combating human trafficking. American Journal of Nursing , 111 (2), 28-37. Scott, S., & Harper, Z. (2006). Meeting the needs of sexually exploited young people: The challenge of conducting policy-relevant research. Child Abuse Review , 15, 313-25.

References Shared Hope International. (2010). Shared Hope International. http://www.sharedhope.org Smith, L., Vardaman, S., & Snow, M. (2009). The national report: Domestic minor sex trafficking - America's prostituted youth. Vancouver, WA: Shared Hope International. The Nest Foundation. (2011). Playground. Retrieved February 18, 2011, from The Nest Foundation: http://nestfoundation.org/ U. S. Department of Health and Human Services. (2011, January 31). Administration for Children and Families. http://www.acf.hhs.gov/trafficking/ U. S. Department of Justice. (2010). Child Exploitation and Obscenity Section. http://www.justice.gov/criminal/ceos/index.html

References U. S. Department of State. (2010). Trafficking in Persons Report. Washington DC: U. S. Department of State. U.S. Department of Health and Human Services. (2007). Senior policy operating group on trafficking in persons- Subcommittee on domestic trafficking final report. Washington DC: U. S. Department of Health and Human Services. United Nations Office on Drugs and Crime (UNODC). (2011). Online Edition - Toolkit to Combat Trafficking in Persons. http://www.unodc.org/unodc/en/human-trafficking/electronic-toolkit-to-combat-trafficking-in-persons---index.html#6 Zimmerman, C., Hossain, M., Yun, K., Gajdadziev, V., Guzun, N., Tchomarova, M., et al. (2008). The health of trafficked women: A survey of women entering post trafficking services in Europe. American Journal of Public Health , 98 (1), 55-9.